Posted by sweet wendhie from IP 203.87.176.78 on November 02, 2007 at 18:10:00:
In Reply to: what to assess first? posted by mommy on October 31, 2007 at 05:48:58:
hi there mommy?! i am certain that you should assess 1st - s/p laryngectomy 2 hours ago with productive cough and small erythema on the suture line rather than MI 3 days ago with 3 PVC in one minute. i am sure with this answer mommy! this is my rationale over this question.. consider ABCs - airway and breathing first which points out to laryngectomy.. MI speaks about circulation.. secondly, it is a matter of concern that a post OR of laryngectomy predisposes your patient to laryngeal swelling as evidenced by a small erythema which poses a risk for ineffective airway.. Take note of productive cough, cough itself is a threat that your sutures may break down causing hemorrhage on your patient.. MI 3 days ago although it may sound serious, yet the mere fact that it is 3 days ago is now more stable.. the area of concern should be within the 1st 12 - 24 hrs.. PVCs although critical but not to be worried about unless the patient exhibits 6 consecutive PVCs in a minute..
hope that you are being enlightened by my answer.. should you have any other concerns, just post it up so i can answer as soon as i get the time to. GOD Bless you MOMMY!